Decisional balance for immoderate drinking in college students.

Immoderate drinking in college is common and is associated with significant negative sequelae. In this study, measures of Decisional Balance for Immoderate Drinking were developed. This construct is proposed to represent the basic decision-making process that is used by students when deciding whether to drink at immoderate levels or not. Furthermore this construct is embedded in a larger model of behavior change, the Transtheoretical Model of Change, which has been shown to be effective in understanding many health-related behaviors across a wide variety of populations. A total of 629 college students were administered a 25-item decisional balance questionnaire in 1993-1994. Exploratory and confirmatory analyses suggested two different solutions, a two-factor solution and a three-factor solution, but did not provide clear evidence for the psychometric superiority of one over the other. The three-factor solution was chosen as it was seen as an elaboration of the two-factor solution, and validity evidence for this solution is presented. The three factors were labeled the Pros, the Cons-Actual, and the Cons-Potential of Immoderate Drinking. The Cons-Actual scale is a measure of negative affective states associated with current drinking whereas the Cons Potential measures the risk of more concrete negative effects of drinking. External validity was established by the significant and meaningful differences on a number of alcohol-related variables including consumption variables, three measures of negative sequelae of immoderate drinking, and Stage of Change, the organizing construct of the Transtheoretical Model of Change.

Computer-based smoking cessation interventions in adolescents: description, feasibility, and six-month follow-up findings.

The impact of adolescent smoking cessation clinics has been disappointing due to low participation rates, high attrition, and low quit rates. This paper describes two computerized self-help adolescent smoking cessation intervention programs: 1) a program utilizing the expert system which is based on the transtheoretical model of change and 2) a popular action-oriented smoking cessation clinic program for teens which was modified for computer presentation. High participation rates in the program among 132 smokers demonstrate the high feasibility and acceptability of the programs. Quit rates of up to 20% were observed during the intervention, and an additional 30% made unsuccessful quit attempt(s). The 6-month follow-up findings indicated that adolescents were poorly prepared to maintain abstinence.

Decisional balance and stage of change for adolescent drinking.

The Transtheoretical Model of Change has been proven very effective in explaining both the acquisition and cessation of many health related behaviors. In this study, this model was applied to the domain of immoderate alcohol use among adolescents (usually drinking three or more drinks per occasion). Measures for two constructs of the model were developed: Stage of Change and Decisional Balance. A total of 853 tenth and eleventh graders who attend vocational training programs were administered a 37-item decisional balance questionnaire and a 5-item staging measure. A short (16-item) psychometrically sound Decisional Balance Inventory was developed based on an exploratory factor analysis that identified two factors, the Pros and Cons of Alcohol Use. The factor structure was confirmed using structural modeling techniques on a hold-out sample. Based on a combination of model fit and parsimony considerations, an uncorrelated model was selected (IFI2 = .909). Students were classified into one of nine stages of acquisition or cessation. External validity was established by the significant and meaningful differences between the stages of change on the pros and cons of alcohol use. Implications of this research are discussed.